Register

Thank you for your interest in the Treehouse4Two Retreat Program.

Due to high demand, we may not be able to offer a place to everyone, but please share your details below, and we’ll be in contact as soon as we can.

Person living with dementia details

First name

Last name

Suburb of the person living with dementia

Postcode of the person living with dementia

Dementia diagnosis

Date of diagnosis

Carer details

First name

Last name

Relationship with the person living with dementia

Carer contact number
Please provide a valid Australian phone number

Carer email (optional)

Where did you hear about Treehouse4Two?